Child Mortality and Injury in Asia

This paper presents an overview of the IRC Child Injury Series, a working paper series on child injury that has its first focus on injury in developing countries. The series summarizes the findings of six national and subnational surveys in Asia: Bangladesh, China (two regions), Philippines, Thailand and Viet Nam. The surveys, undertaken using a new methodology resembling a census, found that injury is the leading cause of death after infancy in children through 17 years of age in all countries surveyed. The methodology involved creating a very large, representative sample of households in each national/subnational survey and directly counting all mortality events in the previous three years and all morbidity events that required missing work, school, or being hospitalized from injury in the previous one year. The results show that prior estimates of child mortality have omitted most injury deaths in early childhood as they did not include children aged five years and over. As a result, injury, which is a leading cause of death in children under five, and the leading cause of death in children aged five years and over, has been largely invisible to policymakers and is not included in child health programmes. The surveys show a consistent pattern of types of injury in the different stages of childhood in the countries surveyed. Drowning, greatly underestimated by traditional methods of surveillance, is the leading injury cause, responsible for over half of all injury deaths in children. Evidence from the surveys shows that the social, health and economic burden of non-fatal injury is significantly high. While falls, road traffic, cuts and burns were found to be leading causes of morbidity, injury caused by animals also emerged as a leading cause of mortality and morbidity. Addressing injury is necessary to continue current progress in child mortality and morbidity reductions in the region.